Abstract
This paper extends work presented earlier (Gaines 1979b) on the relation of psychiatric actors’ definitions of mental illness, seen as folk theories, to professional behavior. A summary of earlier work sees American psychiatry as ethno-psychiatry and examines the role of cultural assumptions in psychiatric theory and emergency room practice. The paper then shows how actors’ definitions affect not only cognitive behaviors such as diagnosis, but also the temporal dimension of interaction with patients themselves. It is shown that differences in etiological definitions affect the length of time a resident spends with a patient before making a disposition. The next section of this paper does two things: First, it suggests that it is useful and possible to distinguish two major “Great” cultural traditions in the West. For each tradition, aspects of world view are sketched. Second, two conceptions of person which correspond to the cultural traditions distinguished, the indexical and referential, are delineated. Lastly, some implications of these differing conceptualizations for psychiatric practice are presented with reference to case material considered in the second section of the paper.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Abram, H. and C. Meador: 1976 Introduction: the Patient, the Physician and the Psychiatrist. In Basic Psychiatry for the Primary Care Physician. H. Abram (ed.). Boston: Little, Brown and Company.
Arensberg, C.: 1963 The Old World Peoples: The Place of European Cultures in World Ethnography. Anthropological Quarterly 36 (3): 75–99.
Bailey, F.: 1971 Gifts and Poisons: the Politics of Reputation. New York: Schocken Books.
Bateson, G.: 1976 Naven. Stanford: Stanford University Press. (1936).
Belmonte, T.: 1979 The Broken Fountain. Chicago: University of Chicago Press.
Boehm, C.: 1980 Exposing the moral self in Montenegro. American Ethnologist 7: 1–26.
Boissevain, J.: 1980 A Village in Malta. New York: Holt, Rinehart and Winston.
Bott, E.: 1971 Family and Social Network. London: Tavistock.
Bourguignon, E.: 1965 The Self, the Behavioral Environment, and the Theory of Spirit Possession. In Context and Meaning in Anthropology. M. Spiro (ed.). New York: Free Press.
Campbell, J.: 1964 Honour, Family and Patronage. Oxford: Oxford University Press.
Clark, M.: 1959 Health in the Mexican-American Culture. Berkeley: University of California Press.
Cohen, A.: 1948 On the Place of Themes and Kindred Concepts in Social Theory. American Anthropologist 50: 436–443.
Crapanzano, V.: 1980 The Subject as Object: The Phenomenology of Encounter. Paper presented at the 24th Annual Meeting of the American Academy of Psychoanalysis: San Francisco, May.
Dubois, C.: 1936 The Wealth Concept as an Integrative Factor in Tolowa-Tututni Culture. In Essays in Anthropology Presented to A. L. Kroeber. R. Lowie (ed.). Berkeley: University of California Press.
Dubois, C.: 1955 The Dominant Value Profile of American Culture. American Anthropologist 47: 1232–1239.
Ebeling, G.: 1970 Luther: An Introduction to His Thought. R. Wilson (trans.). Garden City, NY: Doubleday and Company.
Eickelman, D.: 1955 Moroccan Islam. Austin: University of Texas Press.
Entralgo, L.: 1970 The Therapy of the Word in Classical Antiquity. New Haven: Yale University Press.
Erickson, C.: 1976 The Medieval Vision: Essays in History and Perception. New York: Oxford University Press.
Fabrega, H.: 1974 Disease and Social Behavior. Cambridge: The MIT Press.
Foster, G.: 1953 Relationship Between Spanish and Spanish-American Folk Medicine. J. American Folklore 66: 201–217.
Foulkes, E.,: 1977 The Italian Evil Eye. Journal of Operational Psychiatry 8: 28–34.
Friedl, E.: 1967 The Position of Women: Appearance and Reality. Anthropological Quarterly 40: 97–108.
Gaines, A. D.: 1979a Psychiatry as a Cultural System. Invited Grand Rounds, Department of Psychiatry, John A. Burns School of Medicine. Honolulu, April.
Gaines, A. D.: 1979b Definitions and Diagnoses. Culture, Medicine and Psychiatry 3(4):381 –418.
Gaines, A. D.: 1979c The Word and the Cross: Ascendant Alsatian Ethnicity and Religious Affiliation in Strasbourg, France. Ann Arbor: University Microfilms International.
Gaines, A. D.: 1980 Race and Culture as Cultural Systems: Ethnicity in Strasbourg. Paper presented at 79th Annual Meetings of the American Anthropological Association meeting, Washington, D.C., December 4–7, 1980.
Gaines, A. D.: 1981 Faith, Fashion and Family: Religious Aesthetics and Family Social Organization in Strasbourg. Unpublished manuscript.
Gaines, A. D.: 1982 Knowledge and Practice: Anthropological Ideas and Psychiatric Practice. In Clinically Applied Anthropology: Anthropologists in Health Science Settings. N. Chrisman and T. Maretzki (eds.). Dordrecht, Holland: D. Reidel (in press).The Word and the Cross: Cultural Identities and Paradox in Alsace. Cambridge: Schenkman (in press).
Geertz, C.: 1973a Thick description: Toward an Interpretive Theory of Culture. In The Interpretation of Cultures. C. Geertz (ed.). New York: Basic Books.
Geertz, C.: 1973b Ethos, World View and the Analysis of Sacred Symbols. In The Interpretation of Cultures. C. Geertz (ed.). New York: Basic Books.
Geertz, C.: 1977 On the Nature of Anthropological Understanding. Annual Editions in Anthropology. Guilford, Connecticut: Dushkin.
Gilbert, D. and D. Levinson: 1958 Ideology, Personality and Institutional Policy in a Mental Hospital. American Journal of Abnormal and Social Psychology 53: 263–371.
Good, B.: 1977 The Heart of Whats the Matter: The Semantics of Illness in Iran. Culture, Medicine and Psychiatry 1: 25–58.
Good, B. and M. DelVecchio Good: 1980 The Meaning of Symptoms: A Cultural Hermeneutic Model for Clinical Practice. In The Relevance of Social Science for Medicine. L. Eisenberg and A. Kleinman (eds.). Dordrecht, Holland: D. Reidel.
Hall, A. and P. Bourne: 1973 Indigenous Therapists in a Southern Black Urban Community. Archives of General Psychiatry 28: 137–142.
Hallowell, A.: 1955 The Self and Its Behavioral Environment. In Culture and Experience. A. I. Hallowell (ed.). Philadelphia: University of Pennsylvania.
Harrison, B.: 1972 Meaning and Structure: An Essay in the Philosophy of Language. New York: Harper and Row.
Harwood. A.: 1977 Rx: Spiritist as Needed. New York: John Wiley.
Herskovitz, Melville J.: 1941 The Myth of the Negro Past. New York: Harper and Row.
Hillard, J. and W. Rockwell: 1978 Disesthesia, Witchcraft and Conversion Reaction. Journal of the American Medical Association 240 (6): 1742–1744.
Hufford, D.: 1977 Christian Religious Healing. Journal of Operational Psychiatry 8: 22–27.
Kapferer, B.: 1979. Mind, Self, and Other in Demonic Illness. American Ethnologist 6: 110–133.
Kenny, M.: 1966 A Spanish Tapestry. New York: Harper Colophon.
Kiev, A.: 1968 Curanderismo. New York: Free Press.
Kleinman, A.: 1977a Problems and Prospects in Comparative Cross-Cultural Medical and Psychiatric Studies. In Culture and Healing in Asian Societies. A. Kleinman et al. (eds.). Cambridge: Schenkman.
Kleinman, A.: 1977b Rethinking the Social and Cultural Context of Psychopathology and Psychiatric Care. In Renewal in Psychiatry. T. Manschreck and A. Kleinman (eds.). Washington, D. C.: Hempisphere Publishing Company.
Kleinman, A.: 1980a Major Conceptual and Research Issues for Cultural (anthropological) Psychiatry. Culture, Medicine and Psychiatry 4 (3): 3–13.
Kleinman, A.: 1980b Patients and Healers in the Context of Culture. Berkeley: University of California Press.
Kleinman, A., L. Eisenberg, and B. Good: 1978 Culture, Illness and Care: Clinical Lessons from Anthropological and Cross- Cultural Research. Annals of Internal Medicine 88: 251–258.
Kluckhohn, F.: 1950 Dominant and Substitute Profiles of Cultural Orientation. Social Forces 28: 376–393.
Lacan, J.: 1968 The Language of the Self. A. Wilden (trans.). Baltimore: Johns Hopkins Press.
Laget, M.: 1980 Childbirth in Seventeenth and Eighteenth Century France. In Medicine and Society in France: Selections from Annals, Vol. 6. R. Forster and O. Ranum (eds). Baltimore: Johns Hopkins University Press.
Lebra, T.: 1976 Japanese Patterns of Behavior. Honolulu: The University Press of Hawaii.
Lee, D.: 1959 Freedom and Culture. Englewood Cliffs, NJ: Prentice-Hall.
Lee, D.: 1959a Personal Significance and Group Structure. In Freedom and Culture. D. Lee (ed.). Englewood Cliffs, New Jersey: Prentice-Hall.
Lee, D.: 1959b The Conception of Self Among the Wintu. In Freedom and Culture. D. Lee (ed.). Englewood Cliffs, New Jersey: Prentice-Hall.
Lee, D.: 1959c View of the Self in Greek Culture. In Freedom and Culture. D. Lee (ed.). Engle-wood Cliffs, New Jersey: Prentice-Hall.
Lefley, H.: 1979 Prevalence of Potential Falling-Out Cases Among the Black, Latin and Non-Latin White Population in the City of Miami. Social Science and Medicine 13B: 113–114.
Light, D.: 1976 Work Styles Among American Psychiatric Residents. In Anthropology and Mental Health. J. Westermeyer (ed.). The Hague: Mouton.
Marsella, A. J., D. Kinzie, and P. Gordon.: 1973 Ethnic Variations in the Expression of Depression. Journal of Cross-Cultural Psychology 4: 435–458.
Marsella, A. J.: 1979 Cross-Cultural Studies of Mental Disorder. In Perspectives on Cross-Cultural Psychology. A. J. Marsella et al. (eds.). New York: Academic Press.
Metraux, R.: 1954 Themes in French Culture. Palo Alto: Stanford University Press.
Michaelson, M.: 1972 Can a Root Doctor Actually Put A Hex On Or Is It All A Great Put-On? Todays Health, March, p. 39ff.
Mitchell, F.: 1978 Hoodoo Medicine. Read, Cannon and Johnson Co.
Murphy, H. B. M.: 1976 Notes for a Theory of Latah. In Culture-bound Syndromes, Ethnopsychiatry and Alternate Therapies. W. Lebra (ed.). Honolulu: University Press of Hawaii.
Opler, M.: 1945 Themes as Dynamic Forces in Culture. American Journal of Sociology 51:198– 206.
Peristiany, J.: 1974 Honour and Shame: The Values of Mediterranean Society. Chicago: University of Chicago Press.
Pierce, C. S.: 1931 Collected Papers. Vols. 1-6. C. Hartshorne and P. Weiss (eds.). Vols. 7–8. A. 1958 Burks (ed.). Cambridge: Harvard University Press.
Quinn, N.: 1979 A Cognitive Anthropologist Looks at American Marriage. Paper presented at the 78th Annual Meetings of the American Anthropological Association. Cincinnati, Ohio, November 28-December 1,1979. A Folk Theory of Child Training. Manuscript. Duke University.
Rogers, S.: 1975 Female Forms of Power and the Myth of Male Dominance. American Ethnologist 2: 727–756.
Rubel, A.: 1971 Across the Tracks: Mexican-Americans in a Texas City. Austin: University of Texas Press for the Hogg Foundation.
Rubin, J. and J. Jones: 1979 Falling-Out: A Clinical Study. Social Science and Medicine 13B: 117–127.
Snow, L.: 1977 Popular Medicine in a Black Neighborhood. In Ethnic Medicine in the Southwest. E. Spicer (ed.). Tucson, Arizona: University of Arizona Press.
Stack, C.: 1974 All Our Kin. New York: Harper and Row.
Strauss, A.: 1977 Northern Cheyenne Ethnopsychology. Ethos 5: 326–357.
Tanaka-Matsumi, J. and A. J. Marsella: 1976 Cross-culural Variations in the Phenomenological Experience: I. Word Association Studies. Journal of Cross-Cultural Psychology 7: 379–396.
Townsend, J. M.: 1975 Cultural Conceptions and Mental Illness: A Controlled Comparison of Germany and America. Journal of Nervous and Mental Disease 160: 409–421.
Townsend, J. M.: 1978 Cultural Conceptions and Mental Illness: A Comparison of Germany and America. Chicago: University of Chicago Press.
Townsend, J. M.: 1979 Stereotypes of Mental Illness: A Comparison with Ethnic Stereotypes. Culture, Medicine and Psychiatry 3 (3): 205–230.
Turkle, S.: 1978 Psychoanalytic Politics: Freud’s French Revolution. New York: Basic Books.
Valentine, C.: 1963 Men of Anger and Men of Shame: Lakalai Ethnopsychology and Its Implications for Sociopsychological Theory. Ethnology 2: 441–477.
Vogt, E.: 1951 Navaho Veterans: A Study of Changing Values. Peabody Museum of Harvard University, Vol. 41.
Wallace, D. T.: 1978 I Am A Drunk: Redefinition of the Self in Alcoholics Anonymous. Manuscript. San Francisco State University.
Weber, M.: 1954 The Sociology of Religion. E. Fischoff (trans.). Boston: Beacon Press.
Weidman, H.: 1979 Falling-Out. Social Science and Medicine 13B: 95–112.
White, G.: 1978 Ambiguity and Ambivalence in Aara Personality Descriptors. American Ethnologist 5: 334–360.
Wolf, E.: 1969 Society and Symbols in Latin Europe and the Islamic Near East. Anthropological Quarterly 42: 287–301.
Wylie, L.: 1970 Les Francais. Englewood Cliffs, NJ: Prentice-Hall.
Wylie, L.: 1974 Village in the Vaucluse. Cambridge: Harvard University Press.
Yap, P.M.: 1969 The Culture-Bound Reaction Syndromes. In Mental Health in Asia and the Pacific. W. Caudill and T. Y. Lin (eds.). Honolulu: East-West Center Press.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1982 D. Reidel Publishing Company
About this chapter
Cite this chapter
Gaines, A.D. (1982). Cultural Definitions, Behavior and the Person in American Psychiatry. In: Marsella, A.J., White, G.M. (eds) Cultural Conceptions of Mental Health and Therapy. Culture, Illness, and Healing, vol 4. Springer, Dordrecht. https://doi.org/10.1007/978-94-010-9220-3_6
Download citation
DOI: https://doi.org/10.1007/978-94-010-9220-3_6
Publisher Name: Springer, Dordrecht
Print ISBN: 978-90-277-1757-3
Online ISBN: 978-94-010-9220-3
eBook Packages: Springer Book Archive